Healthcare News

2010-2011 ICD-9 Changes Ready for October
July 27, 2010

Additions, revisions, and newly truncated ICD-9 codes will be effective October 1, 2010.

We have prepared the 2010-2011 changes to ICD-9 codes. A summary of these changes is available to current clients by logging in and visiting the Clients Only page. If you have questions or would like a copy emailed to you, contact support@yostengineering.com.

Migration to New ABN Assistant WEB Platform Completed
March 11, 2010

Migration to the new ABN Assistant WEB platform has been completed this week.  Note the following enhancements and features which have been implemented along with general performance improvements:

• Complete suite of administrative tools -- enable or disable access to any feature in the site, by user.  Completely disable specific tabs if desired, control how files are shared, whether users can set up their own customized data, and more.

• No separate administrator login -- access all administrative functions by loggin in under the normal user account and then clicking on Admin Mode.  When in Admin mode, the screen is black and white as a reminder that you are in Admin mode, not user mode.

• User passwords -- password changes and other settings have moved to Options.

• Admin mode group management -- for each user group, establish whether they inherit the system data from the level above them (ie, use the facility-wide chargemaster, or use a group-specific chargemaster).  This can be very useful for providing laboratory and radiology charge information to affiliated groups such as physician offices, while still allowing them to set up their own favorites, notes, etc.

• Admin mode user access -- for each user, establish access to each tab and function.  Assign Administrative privileges by specific function (ie, assign someone an Administrative role, but give them access only to chargemaster or alias management, and not other admin tools).  Establish for each user whether they share the group or facility files, or use only their own settings.

• Admin mode file templates -- set up physicians, charges, aliases, ABN forms, fee schedule conversion factors, code favorites, and more, and set those as default templates for all users within the group or entire facility.

• ABN Access Report -- view access by for any patient name or ID, by any selected user, for auditing appropriate access policies and access violations.

New and deleted CPT codes will be effective January 1, 2010.

We have prepared the 2010 changes to CPT codes. A summary of these changes is available to current clients by logging in and visiting the Clients Only page. If you have questions or would like a copy emailed to you, contact support@yostengineering.com.

Medical Necessity Guide Available
October 22, 2009

"Medical Necessity Management: Simple Solutions, Big Benefits, a Resource Guide for Providers" is now available for download from the ABN Assistant product pages and through the Clients Only page. This helpful 12-page guide provides a brief overview of the regulatory environment, the process challenges, and key factors in implementation success, as well as a checklist to help you determine your needs.

2009-2010 ICD-9 Changes Ready for October
July 2, 2009

Additions, revisions, and newly truncated ICD-9 codes will be effective October 1, 2009.

We have prepared the 2009-2010 changes to ICD-9 codes. A summary of these changes is available to current clients by logging in and visiting the Clients Only page. If you have questions or would like a copy emailed to you, contact support@yostengineering.com.

2009 CPT Changes Ready for January
October 20, 2008

New and deleted CPT codes will be effective January 1, 2009.

We have prepared the 2009 changes to CPT codes. A summary of these changes is available to current clients by logging in and visiting the Clients Only page. If you have questions or would like a copy emailed to you, contact support@yostengineering.com.

YEI Healthcare Analysts Certified
September 20, 2008

Congratulations to Tonya and Melissa, the latest YEI Healthcare Policy Analysts to be awarded their Certified Professional Coder (CPC) credentials after successfully passing the national certification exam offered by the American Academy of Professional Coders (AAPC). Great job!

New ABN Form Introduces New Requirements for Use
September 5, 2008

The new ABN form was released for use as of March 2008, and its use is required no later than March 2009. Although preliminary instructions were released with the new form, CMS has now updated the CMS Manual System with new requirements and ABN delivery instructions. We strongly recommend that you review the instructions in their entirety (Transmittal 1587, available on the Clients Only page under Medicare Resources), but we have also provided a brief list of important changes below:

• New ABN form replaces previous ABN and ABN lab forms, and also replaces the NEMB forms
• New form may be placed in use immediately, but no later than March 1, 2009
• Use is required for reasons of medical necessity, and is optional for services/supplies that are excluded from Medicare coverage, routine eye/dental/foot care, routine physicals and screenings, and other uses that previously were covered on the NEMB form.
• One ABN form may be used to cover multiple providers involved in delivery of a single service (ordering, rendering, technical, professional, etc.)
• An ABN is required not only for the beginning of treatment, but also for reductions or terminations of service based on medical necessity.
• ABNs may ONLY be completed in English or Spanish. Translations to other languages are not allowed. Patients unable to understand the form in either language may be provided translator services to help them understand the form. Any use of translators should be noted on the form.
• The patient identification number is optional. It may be a patient account number, medical record number, or other internal tracking number. The patient identification number MUST NOT be the Medicare or Social Security number of the patient.
• For repetitive or continuous noncovered care, note the frequency and/or duration of the planned service.
• Estimated costs for the treatment are required. Estimated costs should be within $100 or 25% of the actual costs, whichever is greater. Cost ranges and/or maximum amounts are acceptable.
• An ABN may be considered effective for up to 1 year.
• When in-person delivery of an ABN is not possible, ABNs may be provided via telephone contact, mail, fax, or email. The provider must note how contact was made, and telephone contacts must be immediately followed up with a hand-delivered, mailed, emailed, or faxed notice to be signed by the patient and returned to the provider.
• ABN usage in the emergency department may be appropriate in cases where the patient is medically stable with no emergent health issues.

2008 ICD-9 Changes Ready for October
July 11, 2008

Additions, revisions, and newly truncated ICD-9 codes will be effective October 1, 2008.

We have prepared the 2008 changes to ICD-9 codes. A summary of these changes is available to current clients by logging in and visiting the Clients Only page. If you have questions or would like a copy emailed to you, contact support@yostengineering.com.

ABN Assistant integrates new ABN form
April 17, 2008

ABN Assistant users and administrators should note that Release 2006i will be available on May 5, 2008.

The 5/5/08 patch to ABN Assistant will include the following new features and changes:

• New CMS 131-R-131 ABN form in English (must be implemented by September 1st)
• New CMS 131-R-131 ABN form in Spanish (must be implemented by September 1st)
• New Report Option: Procedures with Rejections. Specify threshold for ABNs generated, and receive procedure code, description, total quantity, and dollar value.
• New Report Option: Top Physicians with Rejections. Specify threshold for ABNs generated, and receive physician name, total quantity, and dollar value.
• New Report Option: Physician Detail for Procedure Code. Specify procedure code, receive a list of physicians who had an ABN issued for that procedure, total number generated, percentage of all ABNs generated for that procedure, and dollar value.
• New Report Option: Rejections for Physician. Specify physician, receive a list of all procedures which generated ABNs, description, quantity, and dollar value.

(Note that this report data is available within existing reports, but these new reports provide an easy way to format and request the information without running more than one report, and without the need to reformat them on the user end. Thanks for the user suggestions!)

If you have any questions about the changes or installing the upgrade, please contact us!

FREE-NPI" Utility Released
March 21, 2008

The YEI FREE-NPI" tool was released today for general purpose use. The tool is free to use, and requires no registration. Users may search information by NPI number, provider name, or facility name. Software vendors and web service providers who would like to implement the tool in their own products can contact sales@yostengineering.com for licensing options. Standard and custom versions of the tool and databases are available.

CMS Releases New ABN form CMS-131-R
March 3, 2008

After long delays, on March 3, 2008, CMS has finally released the new ABN form. The new form replaces both the general use and laboratory use forms, as well as the NEMB forms. The forms were released on March 3, 2008, and must be implemented no later than September 1, 2008.

At this time, CMS has only released the English version of the new forms, and the Spanish one should be posted in the next few weeks. Our programmers are preparing the new formats, and will release an ABN Assistant version upgrade as soon as the final Spanish version is released. You should see the new versions in April or May, depending on how quickly CMS releases the Spanish version of the form.

You may review copies of the new forms and instructions under CLIENTS ONLY once you log in (the new forms and documentation are under the Medicare Documentation section).

Let us know if you have any questions, support@yostengineering.com

[CMS Official Announcement Follows]

ANNOUNCEMENT OF THE IMPLEMENTATION OF THE REVISED ABN MARCH 3, 2008

On Monday, March 3, 2008, CMS will implement use of the revised Advance Beneficiary Notice of Noncoverage (ABN) (CMS-R-131). This form replaces the General Use ABN (CMS-R-131-G), and the Lab ABN (CMS-R-131-L) for physician ordered laboratory tests. The form and notice instructions will be posted on the Beneficiary Notice Initiative web page (www.cms.hhs.govbni). We will post updated manual instructions and the Spanish version of the form on the BNI web page in the near future.

Some key features of the new form are that it:

• Has a new official title, the Advance Beneficiary Notice of Noncoverage (ABN), in order to more clearly convey the purpose of the notice;
• Replaces both the existing ABN-G and ABN-L;
• May also be used for voluntary notifications, in place of the Notice of Exclusion from Medicare Benefits (NEMB);
• Has a mandatory field for cost estimates of the items/services at issue; and
• Includes a new beneficiary option, under which an individual may choose to receive an item/service, and pay for it out-of-pocket, rather than have a claim submitted to Medicare.

CMS will allow a 6-month transition period from the date of implementation for use of the revised form and instructions. Thus, all providers and suppliers must begin using the new ABN (CMS-R-131) no later than September 1, 2008. Questions about the new ABN may be sent to RevisedABN_ODF@cms.hhs.gov .

2008 CPT and HCPCS Changes Ready for January
December 10, 2007

Additions, revisions, and newly deleted CPT and HCPCS codes will be effective January 1, 2008.

We have prepared the 2008 changes to CPT and HCPCS codes. A summary of these changes is available to current clients by logging in and visiting the Clients Only page, starting Monday, 12/10. If you have questions or would like a copy emailed to you, contact support@yostengineering.com.

Policy Change Reports Distributed to All Clients
August 17, 2007

Starting August 16th, 2007, ABN Assistant clients will now automatically receive a Change Report attached to their data update email notifications. These change reports will include the following:

• New CPT codes with LCDs or NCDs
• CPT codes no longer subject to an LCD or NCD
• New, changed, and deleted diagnosis codes on LCDs and NCDs
• Changes to other supporting information for any local or national policies

If you have any questions about the reports, or want the reports sent to any additional individuals at your facility, just let us know at support@yostengineering.com.

2007 ICD-9 Changes Ready for October
July 23, 2007

Additions, revisions, and newly truncated ICD-9 codes will be effective October 1, 2007.

We have prepared the 2007 changes to ICD-9 codes. A summary of these changes is available to current clients by logging in and visiting the Clients Only page, starting Thursday, 7/26. If you have questions or would like a copy emailed to you, contact support@yostengineering.com.

New ABN Forms Enter Second Comment Period
May 25, 2007

The proposed new ABN form was revised again by CMS after feedback received during the first comment period. The form has been primarily changed to streamline the language on the form and to try to improve some of the layout and format issues that were raised. The newest version also allows greater flexibility in labeling the columns and also provides an "Additional Information" area that may be used in a very flexible way for providing additional information, or noting that a patient refused to sign and getting a witness signature.

To review the newest version, which is open for public comment, go to http://www.cms.hhs.gov/PaperworkReductionActof1995 and then click on "PRA listing" and then "CMS-R-131." Any additional comments must be made by June 24th.

There is no date for implementation of the new form, although it is expected to be this summer or early Fall. We will continue to keep you updated on any news on the revised forms and/or completion requirements.

Additional News about the New ABN Forms
March 28, 2007

The instructions for the new ABN Form that has been proposed and is scheduled to become effective in July, now include the following language:

"If a beneficiary chooses to receive some, but not all of the items or services that are subject of the notice, the items and services in Blank (D) that they do not wish to receive may be crossed out, if this can be done in a way that also clearly strikes the reason(s) and cost information in Blanks (E) and (F) that correspond to that care. If this cannot be done clearly, a new ABN must be prepared."

This will provide an easier way to allow patients to choose to accept only some of the services, without having to re-generate multiple forms after they have reviewed the information and stated their preferences. This also provides official CMS guidance that the form remains valid if patients designate their wishes in this way.

For facilities generating paper ABN forms, the patient may mark such notations directly on the printed ABN form. For facilities using the e-signature module, the system already provides an option for allowing patients to choose to accept or refuse each procedure/test while they are signing the signature pad.

We will continue to keep you updated on any news on the revised forms and/or completion requirements.

YEI Healthcare Operations Officer to Speak at OHIMA
March 27, 2007

YEI's Healthcare Operations Officer, Francesca Hartop, will be speaking at the Ohio Health Information Management Association's Annual Meeting. The session is titled "Patient Access to Meaningful Price Information: Why is it so hard?" A summary of her presentation is available through our office.

CMS Proposes ABN Form Changes, Comments Sought
February 23, 2007

CMS has published a revised version of the ABN form, and is seeking feedback on the new format. Public comments may be made until April 24, 2007. Significant changes include:

• A cost estimate will become mandatory
• There will only be one format, and the old lab version of the ABN form will become invalid
• The provider information header must include a telephone number
• The patient name must include a middle name or initial if present on the patient's Medicare card
• The identification number may now be a hospital patient number, Medicare ID number, or other identification number
• A maximum of 6 services per ABN may be entered
• If patients want to continue (approve) only some of the services, the ABN must be broken into at least 2 forms. One for services the patient wants to receive, and one for services they are declining.
• The ABN form must be both signed and dated by the beneficiary. The date should not be automatically generated.
• The name of the form has been changed to "Advance Beneficiary Notice of Noncoverage (ABN)"
• ABN forms must be delivered to the patient in hard-copy (paper) format. However, patient signatures may be stored electronically.

The new ABN format is expected to be formalized in approximately June. YEI will of course provide a patch to update all users' systems with the new form as soon as it is approved for use. If you have any questions or concerns, or need additional information about the proposed changes, please contact our office.

ABN Assistant" Supports e-Signature Module
January 17, 2007

Yost Engineering has integrated support for the e-Signature module into its core ABN Assistant software for medical necessity. YEI can provide the signature pads, setup and ongoing maintenance of the signature pads. This optional module allows facilities to quickly and easily collect electronic signatures directly onto an ABN (Advance Beneficiary Notice) form using an electronic signature pad.

If interested, please contact support@yostengineering.com.

ABN Assistant version 2006F
December 28, 2006

The version F patch was released, and contains the following changes:

• Medicare-compliant LAB-version of ABN form added in both English and Spanish
• Added a Coverage Guidelines reason to the standard ABN checking results
• Integrated the eSignature Module option for clients subscribing to that feature